When Teens Have Bipolar Disorder

If you met Jordan (not his real name), you might be surprised to learn that he has bipolar disorder. President of his senior class and lead actor in the school play, Jordan is outgoing, popular, and a high achiever. But that wasn't always the case.

When Jordan turned 16, his mood suddenly changed. He felt irritable, angry, and extremely fatigued. When he wasn't at school, he locked himself in his bedroom, sleeping all afternoon or playing "dark" video games. His parents noticed the dramatic change, and realized that it was more than an adolescent mood swing. Jordan needed medical intervention.

He and his parents talked to a psychiatrist, a doctor who specializes in treating bipolar and other mood disorders. They discussed Jordan's recent mood swings, along with his increased need for sleep, his temper fits, and his desire to be alone all the time. Jordan talked openly about his feelings of hopelessness, sadness, and worthlessness. His mother also mentioned a time a few months before, when Jordan was unusually energetic, talkative, and excitable -- the opposite of the sadness he now felt.

The psychiatrist diagnosed Jordan with bipolar disorder and prescribed a medication to regulate the extreme highs and lows of the illness. She also started Jordan in regular cognitive psychotherapy sessions to help educate him and his parents about the mood disorder and its treatment.

What Is Bipolar Disorder?

Bipolar disorder is characterized by dramatic or unusual mood swings between major depression and extreme elation, or mania. The mood swings can be mild or extreme. They can come on slowly or quickly, within hours to days. Bipolar disorder usually starts between 15 and 30 years of age. It's more prevalent in those teens who have a family history of the mood disorder.

There are two subtypes of bipolar disorder: bipolar I and bipolar II:

• With bipolar I, the teenager alternates between extreme states of depression and intense mania. With the mania, the teen might be abnormally happy, energetic, and very talkative, with no need for sleep for days. He or she might also have hallucinations, psychosis, grandiose delusions, and/or paranoid rage, all of which might require hospitalization and medications. Once bipolar I begins, it typically persists throughout the person's life.
• With bipolar II, the teen has depression but a lesser form of elation called "hypomania." While someone with either mania or hypomania may have grandiose mood and reduced need for sleep, hypomania is a period of incredible energy, charm, and productivity. It's often associated with super-achievers.

While many teens can be irritable with or without bipolar disorder, the irritability that comes with mania or hypomania may be more hostile. Some believe there is a link between ADHD and bipolar disorder. Some 57% of teens who have adolescent-onset bipolar disorder also have ADHD.